24D2167893 CLIA NUMBER - AMERIGRACE HOME CARE LLC

Laboratory Demographics

  • CLIA Code: 24D2167893
  • Facility Name: AMERIGRACE HOME CARE LLC
  • Facility Address: 9633 HALE AVENUE SOUTH
    COTTAGE GROVE, MN
    ZIP 55016
  • Facility Phone: 651 734-3183
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: GRACE O. OYEFESOBI
  • NPI Number: 1558832105
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2167893
LAB Type Assisted Living Facility
Facility Name AMERIGRACE HOME CARE LLC
Street 9633 HALE AVENUE SOUTH
City COTTAGE GROVE
State MN
ZIP 55016
Phone 651 734-3183
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Assisted Living Facility
Lab Director GRACE O. OYEFESOBI

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This page was last updated on: 9/29/2025